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Haemorrhoids are related to changes of cell function in mucosa and submucosa
Christian Klink1, Marcel Binnebösel, Daniel Kämmer
1Department of Surgery, RWTH Aachen University Hospital, Aachen, Germany. cklink@ukaachen.de
Purpose:
Epidemiology and risk factors of haemorrhoidal disease are not well defined. This study tried to evaluate if the appearance of haemorrhoids is related to a disturbed remodelling of the soft tissue of rectal mucosa and submucosa. Therefore, immunohistochemical expression profiles of five parameters as potential mediators in neoangiogenesis (EGFR), in inflammatory cell activity (COX-2), and in cell migration, differentiation, and wound healing (notch-3, c-myc, and beta-Catenin) were analysed (Saed et al., Fertil Steril 83(Suppl 1):1216-1219, 1; Saed et al., Fertil Steril 79:1404-1408, 2; Stojadinovic et al., Am J Pathol 167:59-69, 3).
Methods:
Haemorrhoidal tissue specimens were collected from 44 patients. Healthy rectal mucosa was obtained from 16 non-fixed fresh cadavers and served as control. Histological and immunohistochemical markers like EGFR, COX-2, notch-3, c-myc, and beta-Catenin were analysed semi-quantitatively, separately for mucosal and submucosal layer.
Results:
Significantly increased expressions were found for EGFR, COX-2, and notch-3 in the mucosal and submucosal layer of haemorrhoidal tissue in comparison to normal rectal tissue.
Conclusions:
This finding confirms that haemorrhoidal disease may be regarded as a manifestation of a soft tissue disease.
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